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The Changing Landscape for Stroke Prevention in AF Findings From the GLORIA-AF Registry Phase 2

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机构: [1]Leiden Univ, Med Ctr, Dept Thrombosis & Hemostasis, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands; [2]RTI Hlth Solut, Res Triangle Pk, NC USA; [3]Boehringer Ingelheim GmbH & Co KG, Dept Med, Burlington, ON, Canada; [4]Boehringer Ingelheim GmbH & Co KG, Dept Med, Ingelheim, Germany; [5]Univ Duisburg Essen, Dept Neurol, Duisburg, Germany; [6]Clin & Maternidad Suizo Argentina, Buenos Aires, DF, Argentina; [7]Icahn Sch Med Mt Sinai, New York, NY 10029 USA; [8]Capital Med Univ, Beijing AnZhen Hosp, Dept Cardiol, Atrial Fibrillat Ctr, Beijing, Peoples R China; [9]Boehringer Ingelheim GmbH & Co KG, Global Epidemiol Dept, Ingelheim, Germany; [10]Boehringer Ingelheim GmbH & Co KG, Biostat & Data Sci Dept, Ingelheim, Germany; [11]Hannover Med Sch, Inst Epidemiol Social Med & Hlth Syst Res, Hannover, Germany; [12]Univ Birmingham, Inst Cardiovasc Sci, City Hosp, Birmingham, W Midlands, England
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关键词: atrial fibrillation oral anticoagulation registry

摘要:
BACKGROUND GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available. OBJECTIVES This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. METHODS During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients' baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. RESULTS Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA(2)DS(2)-VASc [ Congestive heart failure, Hypertension, Age >= 75 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score >= 2; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. CONCLUSIONS The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [ GLORIA-AF]; NCT01468701) (C) 2017 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

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出版当年[2016]版:
大类 | 1 区 医学
小类 | 1 区 心脏和心血管系统
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 心脏和心血管系统
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出版当年[2015]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

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第一作者:
第一作者机构: [1]Leiden Univ, Med Ctr, Dept Thrombosis & Hemostasis, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands;
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通讯机构: [1]Leiden Univ, Med Ctr, Dept Thrombosis & Hemostasis, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands;
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